Short and mid‐term characteristics of COVID‐19 disease course in athletes: A high‐volume, single‐center study

Abstract

Introduction At the pandemic's beginning, significant concern has risen about the prevalence of myocardial involvement after SARS‐CoV‐2 infection. We assessed the cardiovascular burden of SARS‐CoV‐2 in a large cohort of athletes and identified factors that might affect the disease course. We included 633 athletes in our study on whom we performed extensive cardiology examinations after recovering from SARS‐CoV‐2 infection. More than half of the athletes ( n = 322) returned for a follow‐up examination median of 107 days after the commencement of their infection. Results Troponin T positivity was as low as 1.4% of the athletes, where the subsequently performed examinations did not show definitive, ongoing myocardial injury. Altogether, 31% of the athletes' rapid training rebuild was hindered by persistent or reoccurring symptoms. Female athletes reported a higher prevalence of return to play (RTP) symptoms than their male counterparts (34% vs. 19%, p = 0.005). The development of long COVID symptoms was independently predicted by increasing age and acute symptoms' severity in a multiple regression model (AUC 0.75, CI 0.685–0.801). Athletes presenting with either or both cough and ferritin levels higher than >150 μg/L had a 4.1x (CI 1.78–9.6, p = 0.001) higher odds ratio of developing persistent symptoms. Conclusion While SARS‐CoV‐2 rarely affects the myocardium in athletes, about one in three of them experience symptoms beyond the acute phase. Identifying those athletes with a predisposition to developing long‐standing symptoms may aid clinicians and trainers in finding the optimal return‐to‐play timing and training load rebuild pace.

COVID-19 in Female and Male Athletes: Symptoms, Clinical Findings, Outcome, and Prolonged Exercise Intolerance—A Prospective, Observational, Multicenter Cohort Study (CoSmo-S)

“…Thus, subclinical LV systolic dysfunction as described in normal subjects recovering from SARS-CoV-2 infection seems to be rather improbable [ 30 ]. These findings are in accordance with other studies in athletes reporting similar rates of abnormalities in ECG and echocardiography [ 1 , 6 , 31 , 32 ]. In the study of Martinez et al, 19 of 789 professional athletes exhibited echocardiographic signs indicative of cardiac injury [ 31 ].…”

“…As a finding of concern, there is a relevant number of athletes still reporting complaints such as a drop in performance, exertional dyspnea, palpitations, sleep disturbances, mood swings, concentration problems, and joint pain as well as a reduced exercise tolerance at follow-up. Similar to our results, post-acute symptoms lasting several weeks have also been reported in a meta-analysis of [ 23 ], while in other studies, 10–15% of the athletes suffered from complaints for longer than 12 weeks after infection [ 25 , 32 ]. We add to these findings with the aspect that well-trained athletes are also at risk for the persistence of complaints in a time frame exceeding half a year.…”

“…In 147 international competing athletes, mainly from Great Britain and Northern Island, 14% of the athletes lost more than 28 days until full training and competition participation [ 2 ]. In other cohorts, the median duration of return to training after COVID-19 ranged from 14 to 30 days [ 24 , 26 , 28 , 32 ], which may be due to different predominant viral variants, a variable vaccination state, and a younger age [ 28 ]. In our study, the higher percentage of athletes coming back “soon” after SARS-CoV-2 infection compared to cNEAs was potentially due to their milder symptoms during the infection.…”

Blood Test–Based Age Acceleration Is Inversely Associated with High-Volume Sports Activity

“…The laboratory testing was carried out approximately 24 d after the athletic subjects' SARS-CoV-2 infection. The detailed results of these tests have been published by Juhász et al (22). Note that written informed consent was obtained from the participants beforehand.…”

“…In this study, we train and test aging clocks based on blood tests and body measurements using the publicly available NHANES database. Additionally, we apply the clocks on a dataset comprising 421 Hungarian athletes previously collected in another study (22).…”